Service de chirurgie orthopédique et traumatologique, centre hospitalier privé Brestois, clinique Pasteur-Lanroze, 29200 Brest, France; LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France.
LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; Université de Bretagne Occidentale, UBO, 3, rue des Archives, CS 93837, 29238 Brest, France.
Orthop Traumatol Surg Res. 2020 Dec;106(8):1523-1526. doi: 10.1016/j.otsr.2020.07.010. Epub 2020 Nov 8.
Interest in the different surgical approaches to total hip arthroplasty remains high, but without any real consensus on which approach is the most beneficial. Several recent technical innovations have made it possible to reduce the risk of dislocation, therefore improving the efficacy of the posterolateral approach. Since 2003, we have been using a modified minimally invasive posterolateral approach called SPARTAQUUS (Spare the Piriformis And Respect The Active QUadratus femoris and gluteus mediUS), which spares the piriformis tendon, the quadratus femoris muscle and the gluteus medius muscle, and involves direct capsular repair. The "active posterosuperior hammock" effect of the piriformis tendon is therefore coupled with the "passive posterosuperior hammock" effect of the capsular repair, thus limiting the risks of posterior dislocation of the prosthetic hip joint.
对全髋关节置换术不同手术入路的兴趣仍然很高,但哪种入路最有益仍没有达成真正共识。最近的一些技术创新使得降低脱位风险成为可能,从而提高了后外侧入路的效果。自 2003 年以来,我们一直在使用一种改良的微创后外侧入路,称为 SPARTAQUUS(保留梨状肌并尊重活跃的股方肌和臀中肌),它保留了梨状肌肌腱、股方肌和臀中肌,并涉及直接囊修复。因此,梨状肌肌腱的“主动后上吊索”效应与囊修复的“被动后上吊索”效应相结合,从而限制了人工髋关节后脱位的风险。